A book review:
This book, Clinical Therapy In Breastfeeding Patients, 2nd ed. by Thomas W. Hale and Pamela Berens, MD (Pharmasoft Publishing, 2002)
can be ordered at (800)-378-1317 or www.perinatalpub.com.
This book answers the questions of "which medication is safe for a breastfeeding mother with a certain syndrome". Hale's other book Medications and Mothers' Milk "provides a compilation of over seven hundred medications" but it "does not provide an overview of the specific medications that may be useful for a particular medical condition, and those that are probably safest for a mother who is breastfeeding an infant".
Hale's book is inexpensive ($23.95 including shipping in USA). He has gained a well deserved reputation for outstanding readability as well as a sensible approach that most conditions in a breastfeeding mother can be treated while breastfeeding continues. He cites current research to back up his opinions.
It is rare that a breastfeeding relationship must cease because of a maternal need for medication yet ignorance in health care providers continues to cause this to happen. Some medications get into mother's milk - yes, but many times in such small amounts as to be insignificant or perhaps they may be inactivated by stomach acid or may not even get into the milk at all. PH of the medication, molecular size and osmolarity all affect the amount of medication that ends up in the mother's milk. Most medications only get in milk in small amounts. If a medication does get into the milk in significant enough amounts to have a negative impact on the infant this book will help the health care provider or the mother involved look at alternatives. Just because one medication is contraindicated doesn't mean an alternative and safe for the baby medication can't be found.
This book should be on the shelf of EVERY health care provider who has contact with women of childbearing age or with breastfeeding children.
If your health care provider doesn't have it, please recommend s/he get it, along with Medications and Mothers' Milk.
Mother's should be reassured that most medical conditions can be treated appropriately while breastfeeding continues. Proper caution dictates each medication be checked with a good resource such as Tom Hale's books.
Updated 1/26/04 to reflect new edition